Financement de la biologie clinique et bonne prescription des analyses Reimbursement and rational prescription of laboratory tests

Following the important growth of the Belgian laboratory medicine budget in the eighties, the mechanisms of reimbursement by the social security system have become more and more complex in the last 20 years. The current system is a dual one, with a lump sum complemented by an amount per test. The rules differ for hospitalized and non-hospitalized patients. New recently launched measures (“ reference amounts ”) intend to decrease the prescription of laboratory tests in hospitals, while others targeting non-hospital practice are being considered. Beside these purely financial initiatives targeting the laboratories, another approach involves fostering a rational prescription of tests according to the results of interventional trials or international guidelines consistent with evidencebased medicine. The recent report of the KCE on laboratory tests prescription by general practitioners is consistent with this strategy.